Drug-store chain CVS Health announced Thursday that it will limit opioid prescriptions in an effort to combat the epidemic that accounted for 64,000 overdose deaths last year alone.

Amid pressure on pharmacists, doctors, insurers and drug companies to take action, CVS also said it would boost funding for addiction programs, counseling and safe disposal of opioids.

[...] The company's prescription drug management division, CVS Caremark, which provides medications to nearly 90 million people, said it would use its sweeping influence to limit initial opioid prescriptions to seven-day supplies for new patients facing acute ailments.

It will instruct pharmacists to contact doctors when they encounter prescriptions that appear to offer more medication than would be deemed necessary for a patient's recovery. The doctor would be asked to revise it. Pharmacists already reach out to physicians for other reasons, such as when they prescribe medications that aren't covered by a patient's insurance plan.

The plan also involves capping daily dosages and initially requiring patients to get versions of the medications that dispense pain relief for a short period instead of a longer duration.

[...] "The whole effort here is to try to reduce the number of people who are going to end up with some sort of opioid addiction problem," CVS Chief Medical Officer Troyen Brennan said in an interview.

It appears this initiative is limited to initial filling of prescriptions — there is no mention of changes in the handling of refills.

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Pain-pill giant Purdue Pharma LP will stop promoting its opioid drugs to doctors, a retreat after years of criticism that the company's aggressive sales efforts helped lay the foundation of the U.S. addiction crisis.

The company told employees this week that it would cut its sales force by more than half, to 200 workers. It plans to send a letter Monday to doctors saying that its salespeople will no longer come to their clinics to talk about the company's pain products.

"We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers," the company said in a statement. Instead, any questions doctors have will be directed to the Stamford, Connecticut-based company's medical affairs department.

OxyContin, approved in 1995, is the closely held company's biggest-selling drug, though sales of the pain pill have declined in recent years amid competition from generics. It generated $1.8 billion in 2017, down from $2.8 billion five years earlier, according to data compiled by Symphony Health Solutions. It also sells the painkiller Hysingla.

Congress has responded strongly to a joint investigation by CBS and The Washington Post (archive) about Drug Enforcement Administration (DEA) employees becoming lobbyists for the pharmaceutical industry, and the passage of a bill in 2016 hobbling the DEA's ability to go after opioid distributors and suspicious drug sales:

Drug overdose deaths in the United States have more than doubled over the past decade. The CDC says 188,000 people have died from opioid overdoses from 1999 to 2015.

Joe Rannazzisi used to run the DEA's diversion control. He told "60 Minutes" correspondent Bill Whitaker that the opioid crisis was aided in part by Congress, lobbyists and the drug distribution industry. The DEA says it has taken actions against far fewer opioid distributors under a new law. A Justice Department memo shows 65 doctors, pharmacies and drug companies received suspension orders in 2011. Only six of them have gotten them this year.

[...] [The] DEA's efforts may have been undermined by the so-called "revolving door" culture in Washington. At least 46 investigators, attorneys and supervisors from the DEA, including 32 directly from the division that regulates the drug industry, have been hired by the pharmaceutical industry since the scrutiny on distributors began.

From The Washington Post:

The chief advocate of the law that hobbled the DEA was Rep. Tom Marino, a Pennsylvania Republican who is now President Trump's nominee to become the nation's next drug czar. Marino spent years trying to move the law through Congress. It passed after Sen. Orrin G. Hatch (R-Utah) negotiated a final version with the DEA.

CVS' MinuteClinics are going virtual. The drugstore chain plans to make video visits available nationwide by the end of the year through a partnership with Teladoc Health, CVS' latest pivot away from retail and toward health-care services. CVS already offers virtual appointments, branded as MinuteClinic Video Visits, in nine states and the District of Columbia.

MinuteClinics treat people with minor illness and injuries like coughs and rashes. These walk-in locations are a way to keep customers coming into CVS' stores as more shoppers buy everyday items on Amazon. Making it possible to visit a MinuteClinic without actually walking into one may hamper that, but it could help CVS reach more people.

With virtual visits, known in the industry as telehealth or telemedicine, CVS can reach people who may not be able to visit one of its roughly 1,100 locations. MinuteClinics are a key part of CVS' $69 billion acquisition of health insurer Aetna.

The morality police are just doing great, pressuring companies into restrictive policies and funding "programs". Too bad it just makes life difficult for people who actually need such medications...but nobody cares about that. It's more important to make sure people can't get high!

As for this supposed "epidemic"? Drugs have been around and readily accessible for a very, very long time. Perhaps this "epidemic" is more reflective of more people being unhappy than it is of drug availability?

No, we can't think like that. Have to crack down on...someone! Make those pharmacies run scared and do everything they can to try to look "hard" on drugs!

Because no-one votes for a sheriff who is soft on crime. Doesn't matter *WHY*, just that he is or looks soft on crime.Chances are, with the data exchange they do with the DEA, the world's largest extra-legal police force, they got sick and tired of the continuous questions they received and just said "fuck this shit, we'll bend".

Just take a look at the DEA and figure out how much money is involved in just running that agency, how many people, and more importantly, how many companies, would lose money if you scaled back the 'war on drugs'. Onces you've got that figured out, you'll know exactly why these things happen and why suddenly this opioid crisis is a thing. The DEA is the equivalent of a mafia enforcer, with the difference that the mafia lives by a code, the DEA lacks that bit.

On the contrary, buddy, on the contrary.Something tells me marijuana oils are equally effective and a lot less addictive.Supplementary, marijuana preparations are cheaper in terms of production costs.

As for this supposed "epidemic"? Drugs have been around and readily accessible for a very, very long time. Perhaps this "epidemic" is more reflective of more people being unhappy than it is of drug availability?

Oh, for fucks' sake. Celebs are visible, for each of them there are thousands of invisible others who "benefited" from the said availability

Virindi, did you miss all the articles about big pharma actually PUSHING drugs that were either not required, or not required in such large doses? We do have a problem today, in that, pharma pushed their dope for profit, without regard for the patient's needs. Opiods are still being pushed. I took a little ride in an ambulance just about a year ago. The ambulance attendants had been indoctrinated to push that damned morphine. I wasn't in serious pain - at worst, I was very uncomfortable. So - morphine. WTF for? There was no good reason to give me morphine, other than to pad the bill for riding to the hospital.

Let me ask you - if you were suffering discomfort that might be confused with a bad case of indigestion, would you ask for morphine? If not, what drugs would you ask for?

Much worse than a single dose in my case, I know TWO men who have been hospitalized for life threatening injuries. Both tell the same story about self-administering morphine. They were told, "If it hurts, just push the button!" Both tell me that they felt no pain - but the morphine felt so good, they turned into button-pushing fools.

Over the past couple decades, the medical community has been irresponsible and negligent by pushing those drugs onto people who don't need them, or need them in much smaller doses than have been offered.

Maybe CVS is over reacting - and maybe not.

I do understand where you are coming from. If you have a genuine NEED for pain relievers, you are NOT in any condition to trot down to the doctor's office every couple days for a script, then traipse to the pharmacy, to wait in line for it to be filled. In cases such as this, the DOCTOR has a responsibility to explain to the pharmacist that there is a genuine NEED for the script, as written. If Doc thinks you need ten pills per day for the next 30 days, then the pharmacist should just fill a couple bottles full, and send you on your way.

"It will instruct pharmacists to contact doctors" is the proper thing to do here, IMHO.

The problem is that opioids are habituating, i.e. not only do you get addicted, but the amount you need to take for a certain amount of relief keeps increasing. So does your tolerance, but more slowly. So for serious pain you "soon" get to the point where you can't relieve the pain without killing yourself, and if you try to quit the pain is worse than it would have been without the opioids in the first place.

Advanced opioids are a truly lousy treatment for chronic pain. I'm not sure this applies to raw opium. Historical records are a bit sketchy and unreliable, but they don't seem to indicate this problem. OTOH, that was mainly for smoked or chewed opium, which has a much slower onset.

So the question becomes, "What better choices are there?". Back when they were still doing research on it, it was reported that LSD could relieve the pain of advanced terminal cancer. Well...it didn't actually relieve the pain, but it caused people to be able to ignore it. This was for cases where the "cocktail" had stopped working. So that might work. Someone earlier recommended marijuana. I'm not really sure. I haven't seen any research on it, but it seems plausible. Mescaline and psilocybin should also be investigated. Note that *NONE* of the drugs I've suggested are addictive. Marijuana is habituating, but not in the same sense as opioids, as the required dose doesn't keep increasing. The others aren't even habituating. LSD has been called "anti-addictive" in that it becomes unpleasant to take multiple doses in close proximity, and if you take them too close together it doesn't even work. Alcohol is a decent pain reliever, but at the doses necessary to relieve pain you become incoherent, and it doesn't reduce inflamation at all.

For some reason people keep recommending acetaminophen, which I don't understand at all. That's one drug I've actually tried, and it doesn't do ANYTHING for me at any safe dose. Aspirin and Ibuprofen are much more effective. But those only work for low levels of pain. At the levels I normally need to deal with they suffice, and if for some reason I can't use them, alcohol suffices...but not for very long at a time. Unfortunately, usually I worry about inflamation as much as pain, which means that alcohol is useless.

The actual answer seems to be that there is no currently validated satisfactory way to deal with chronic pain. The ways that might work are illegal even to investigate. The known traditional methods (chewing cocoa leaves or smoking opium) are illegal, and may have undesirable side effects (besides addiction, a known undesirable side effect). I'm not counting alcohol, as that's QUITE unsatisfactory for chronic pain, and has numerous known undesirable side effects. For acute pain it can be useful.

I feel for you man. And, I have no idea what the answers are. As you say, it's illegal to even research some things that look promising. You've hit everything that I've ever had access to, I think. Personally, I prefer novocodone and oxycontin (spelling?) for severe pain - but both are opioids, and addictive. (wait one - novocodone? Maybe I got that one wrong, internet search suggests that I meant oxycodone)

Acetaminophen seemed to work for me, years ago. In recent years, it's near worthless. The wife has had some "Tylenol 3" that seemed to be very effective. Not sure how or why - what's in it? Ahhh, codeine, another opioid. It seems we just can't get away from opium, without breaking the law.

Personally, if/when the day comes that I'm in chronic, terrible pain, I'll probably explore the cannabis options, and avoid the opium if possible. All of my drug use has been very short term - in fact, I've never finished a pain releiver prescription. I use the drugs to weather the first hours or days of excruciating pain, then wean myself. But - if there's no cure for what's ailing you, then there will be no weaning. Cannabis seems to fill that sort of need better than opium.

The actual answer seems to be that there is no currently validated satisfactory way to deal with chronic pain.

Or rather, there's no way to deal with chronic pain that works for everyone.

In the account you replied to, the anecdote about the self-admining morphine feeling too good to resist... well, I bet most people are like that. When I was in the hospital and in quite a bit of pain, they gave me the morphine shot, and yes, it took the edge off the pain (rather, made me not notice it much), but when they came back and offered it again, I said no. Because for me it didn't feel that good, just a bit less bad.

After that, I've been on hydrocodone for 10 years. Yep, ten years. Without it, I'd have long since blown my brains out. But it just takes the edge off the pain, enough to let me keep going. I have not sought an increase in dosage in any of those ten years, although I have asked for more pills for a given period, just this past year, because the days I can skip a pill are getting fewer. No, I'm not immune to pain or anything, it's just that the opiods don't work all that well on me -- which has helped me not become a junkie on them.

If, though, the various moralizing agencies take these things away from me because other people can't or won't control themselves on them, then I might as well start dealing heroin or whatever the hell works. I don't mind trying within reason to make changes that help those people, just make it still possible for people like me who really do have chronic pain for real medical issues to get what we need to, literally, stay alive.

My wife was in ICU in 2001 when "rate your pain on a scale of 1-10" was just coming into fashion, along with the DIY morphine button on the IV drip. Following the MD's instructions, she was pressing the button to supposedly help control her blood pressure. In reality, the morphine was suppressing her respiration, giving her nightmare hallucinations that were increasing her blood pressure, and necessitating an oxygen cannula which caused her nasal septum to crack and bleed and cause her more stress...

I think many "standard of care" practices are applied in ways that increase billable event bottom lines, with little or no regard to the patient beyond trying not to kill them, because that's bad for repeat business...

There is a centralized database of addictive prescriptions to avoid this "doctor shopping" problem, but so far its not enforced strongly or not used properly. Addicted people pay good money for prescriptions because addiction is powerful, making redundant or unnecessary pain pills quite lucrative to shady doctors.

Individual liberty is a great theory, but when taken to the extreme it doesn't work out so well in practice. Mostly because people don't bother properly informing themselves before making decisions (see: Anti-Vaxxers).

In any case, this isn't about individual liberty - this is about the free market. You are free to go to a different drug store if you don't want your pharmacist to care for the safety of their customers.

This is not about making life hard for those that need the drugs. This is about preventing people who don't really need the drugs from being hooked on them simply because it will make some doctors (and Big Pharma) some more money. If you do really need the drugs then your doctor will confirm this with CVS and you can walk out with your armful of opioids.

I'm actually a little surprised and impressed that CVS did this. It will place them at a relative disadvantage in the market, as those people who are being oversubscribed will simply go elsewhere (free market). Good for them.

If 64,000 Americans died in terrorist attacks over the last year, all of the sand in the Middle East would already be radioactive glass.

But educating people about drug use/effect/impacts isn't as cool as blowing shit up, nor it be used to scare people into complacency. And don't we all want to play with boom-boom sticks because it just looks cool?

The CDC [cdc.gov] reports that opioid overdose is the #1 cause of death for Americans under the age of 55. It kills more non-elderly people than car crashes, guns, or suicide. The New York Times [nytimes.com] article on it notes an 8-fold increase between 1990 and today. Based on that, I think it's safe to say that they are trying to respond to a real problem. Their approach might not work, but to claim this is nonsense when people are dying by the thousands is flat wrong.

Anecdotally: I live near one of the worst areas for overdose deaths in the US, and have buried 2 acquaintances so far, struck down in young adulthood by heroin. Both of them were injured, took their prescribed opioid painkillers, switched to heroin when the prescription ran out, and tried rehab programs but remained hooked, and it went on to kill them.

The thing is, even if they had been able to keep their prescriptions the legal opioids necessary to relieve the pain would have killed them. Probably not quite as quickly. The problem is that the size of the minimum effective dose keeps increasing, and while the tolerance also increases, it increases more slowly. Opioids are truly lousy for chronic pain, though suited to severe acute pain. Even then there are indications that using an opioid for acute pain makes it more likely that you'll eventually become addicted, perhaps decades later.

That said, there don't seem to be any good choices for severe chronic pain. Certainly none that are legal, and the ones that are illegal are generally illegal to even investigate. Acupuncture is an exception, but reports of it being successful seem to be rare compared to reports of it failing. This could be down to the skill of the practitioner, of course. Skilled meditators seem to be able to suppress extreme acute pain, but I know of no reports on their abilities with chronic pain...and to be effective as a treatment the skill would need to be learned while in the course of chronic pain.

You're assuming that Thexalon's friends were still in pain when they finished their opioid prescriptions. Nothing he said suggests that's the case. More likely (and here's where I make assumptions!) they were simply hooked on an addictive drug.

Actually, I wasn't talking about any particular case. Rather I was talking about characteristics of the opioids. I don't know his friends, and that is irrelevant to my point.

Well, not totally irrelevant. Opioids *are* addictive, and addicts tend, by definition, to strive hard to acquire the drug to which they are addicted. OTOH, I knew a person in college who said that tobacco was a harder drug for him to kick than heroin, and this was later echoed by Synanon. My suspicion is that it varies from individual to individual, but that part of the reason tobacco is so hard to kick is its wide availability. (That's not the only reason. Commercial cigarettes have a secondary addictive substance mixed into the paper. The way I succeeded in quitting the second time was by switching to an organic cigarette [Shermans], and then gradually increasing the time between cigarettes. [The first time was easy. I just quit immediately. That didn't work the second time.])

I applaud them, trying to stay above the rest. But it is really not their problem, and if it gets to the point that they are the ones limiting it then the whole system is broken beyond repair. It should not be up to their discretion. Sure they should maybe keep track of what doctors issue the scripts, and if Dr Feelgood has been prescribing 100 scripts a day forward the info to DEA, but they should not be in business of second guessing medical needs. Plus I'm sure that the pharmacists do not want or need this extra work.

I believe what is really going on here is not that CVS has independently decided to address the problem. Instead, they are being pressured by politicians and law enforcement, who are trying to achieve what they could not otherwise do through coercion. Even if threats are not direct, the axe of the DEA is still there hanging over the heads of the pharmacists. They are trying to make themselves look like team players to try to avoid it.

exactly, this is about local control of people by the feds, plain and simple. it's not enough that you paid for an expensive doctor's visit and wasted time going in to see the quack, now you have to go to a brick and mortar like it's 1965, get put on a fed "doper" list and see if some dipshit whore of the federal government decides you can have your fucking medicine.

if people are dying all over the country, i'm sorry but that's not my fucking problem. all that being said, i don't use any of this shit nor do business with these flu vaccine pushing pieces of shit, but if i broke my leg and this was happening i might lose my shit on these stupid mother fuckers.

You have no idea about pharmacy. They spend six years learning it before being qualified, and they keep studying forever.They know far more than most doctors about drugs, side effects and drug interactions. There are reasons why pharmacists ask what else you are taking, and there are many, many cases where they ring up a doctor and basically say "are you trying to kill this patient? cos that's what these two drugs together will do."

Back in 2015 when I had a big blood clot in my right lung--but *before* they knew that, thinking it was muscle strain--they prescribed me cyclobenzaprine (flexiril), a muscle relaxant that looks a lot like a tricyclic antidepressant, and Tramadol, an opioid painkiller. Now, I'm not a pharmacist, but I did get through most of Kaplan's training course before, ironically, having to quit due to getting sick. And something sounded off about this combination. So I looked it up, and it turns out combining these two is a good way to die of serotonin syndrome. Needless to say I didn't touch either, and it took over two years to run those initial small bottles down to nothing.

I am one of those people who responds really, really well to opioids. They don't just relieve the pain; they make me feel *good.* And for that reason i am never, ever, ever going to get onto them.

Re:Who's still using CVS?Re:Who's still using CVS?(Score: 2) by Grishnakh on Monday September 25 2017, @04:50PM
(3 children)

I miss CVS actually. I remember there was this really handy program in Tk, I forget the name now, but when you ran it on a source file, it would highlight all the lines according to which revision (check-in) each line was last modified in. I've never seen anything like it for other revision control systems, though admittedly I haven't looked that hard. Are there any tools for git which do this?

The other thing I miss about CVS was that I could edit the repository manually, since it was all text-based.

Re:Who's still using CVS?(Score: 1, Informative) by Anonymous Coward on Monday September 25 2017, @09:24PM

That feature is called “blame”. You can get a commandline version by running “git blame”, but any git GUI should have it as well. But if you didn't know it was called blame, it would be difficult to find.

Re:Who's still using CVS?(Score: 2) by FatPhil on Tuesday September 26 2017, @12:10PM

As already mentioned, git blame's nearest to what you want.I didn't like its verbosity (including lines I had no interest in), and found a few self-written scripts using it to suit my workflow better. One was a show/blame combo which would give me the blame context of a commit, which was very useful for identifying the older patches newer tweaks should be squashed into when cleaning up a set of changes for release (and wanting to hide my intermediate mistakes). (It worked on uncommitted changes too, so would tell me which changes I should add -p as a fixup patch for imminent squashing.)

I get prescription medication that is squarely in the sights of the morality police and it sucks. I've been lucky that so far my pharmacy treats it like anything else but I've been warned by my doctor that I'm only lucky. Some pharmacists or technicians will make it a pain to dispense because they assume patients are just drug seekers.

Don't have the pharmacy question doctors; if they think something is up let them report it to the authorities. This is garbage.

It is easy: dispense as written! If certain chemicals make you uncomfortable find another job.

Why shouldn't they question doctors? According to what I've read, doctors routinely prescribe drugs that will kill patients through interactions, because the doctors are negligent in checking for these. Are you saying that pharmacists shouldn't check to make sure drugs won't kill patients, and just blindly prescribe them? Do you realize that's directly against all the training pharmacists take, plus it opens the pharmacy up to massive lawsuits for negligence?

if they think something is up let them report it to the authorities. This is garbage.

The authorities aren't doing anything (useful) about it, and the doctors are negligent. The pharmacies are smartly covering their asses here because the rest of the system has completely and utterly failed. (Only some doctors are negligent, but since patients can "doctor-shop", it only takes a minority.)

One solution: move yourself to a more progressive culture (Colorado is the easy example these days, but there are others) where Barney Fife isn't out to persecute every drug user he can find or imagine.

My father-in-law was a Pharmacist. On many occasions he saved a patient's life by noticing that a doctor had prescribed a drug that was deadly when combined with something else that the patient was already on.

After he semi-retired, he took up a part time job reviewing patient drug profiles. The aim of the job was to reduce the number of medications and complications by using complementary drugs and minimising the number of drugs that were simply to manage side-effects of other drugs. I think his record was getting a patient from 18 different drugs down to 3. Good outcome for the patient. Less money for the pharmacist, but it seems that they genuinely care about the wellbeing of their customers.

Highly concentreted chemical are not safeHighly concentreted chemical are not safe(Score: 0) by Anonymous Coward on Monday September 25 2017, @02:21PM
(10 children)

It is not healthy or at all safe to consume any of these highly concentrated chemicals for an extended period. Painkillers, anti-histamines, ACE inhibitors, beta blockers, statins, anti-depressants, anti-anxiety, etc. All of them are dangerous and will hurt you.

This does *not* mean they cannot be useful tools, but people treat this stuff like candy and then are surprised when they get more and more messed up. Also, once people get on the prescription drug train the list will grow over time. No one has ever done any kind of study of people on your specific list of half a dozen different medications at your doses.

I think at this point all we really know about being healthy and living long is: "eat moderate amounts of fruit, meat, and vegetables; get moderate amounts of exercise; limit your consumption and other activities of pretty much everything else to minimal levels". That is pretty much it.

Re:Highly concentreted chemical are not safeRe:Highly concentreted chemical are not safe(Score: 5, Insightful) by Taibhsear on Monday September 25 2017, @02:48PM
(9 children)

Re:Highly concentreted chemical are not safeRe:Highly concentreted chemical are not safe(Score: 0) by Anonymous Coward on Monday September 25 2017, @03:22PM
(6 children)

I'm not sure I understand your position. Are you saying something like 50% of people currently alive would have died as infants 100 years ago, and those are the people who now need to take pills to live well? Also, I am not someone in particularly good shape. I have been very sedentary for many years until recently. But I had an experience doing medical research and as a result no longer trust that field to advise or help me at all. So I have been trying harder and harder to follow those rules I put forward.

Re:Highly concentreted chemical are not safeRe:Highly concentreted chemical are not safe(Score: 4, Informative) by choose another one on Monday September 25 2017, @10:04PM
(1 child)

I thought the position was clear - but then I pretty much lost the genetic lottery too.

Nothing to do with the changes in infant mortality, which is largely environmental rather than genetic, or Darwin, since most of the people on the drugs you list are beyond breeding age - I am definitely done with breeding. There are genetic components (sometimes a small increase in risk, sometimes a massive one) to many of the long term conditions that kill people in their 40s/50s/60s, cancers, cardiovascular, autoimmunes, etc., and that genetic factor may well be the difference between getting to your 40s or to your 80s.

"eat moderate amounts of fruit, meat, and vegetables;" - check, also almost always cooked from scratch so I know what's gone into it, and limited salt (almost never use it in cooking, never add it after)"get moderate amounts of exercise;" - check, in fact through my 20s and into my 30s I got far more than most people would say was "moderate", probably "moderate" into my 40s"limit your consumption and other activities of pretty much everything else to minimal levels". - checkalso, maintain healthy weight/BMI, healthy cholesterol etc. - checkin fact the doctors couldn't understand why I was there in the hospital with a stroke in my 40s, I didn't appear as high risk in any way.

Basically your rules didn't work. I am now on half the drugs on your "dangerous" list, and a few more that really are (far more) dangerous, to keep me alive. Turns out (after a few years of diagnostic work) I have two autoimmune conditions both of which are thought to have a genetic component, one of them my mother has, and there are multiple stroke victims on my father's side which may be related to the other one. Maybe with a dose of genetic risk from each parent my immune system went haywire earlier in life than it did for them.

Your rules might work for you, they might even work for a majority of people, but there are those that your methods will not work for, simply due to genetics - those people will require pills, or worse, to live, and we do not know who those people are. It could be you, it is me. In fact, I thought along the same lines as you, right up until it was me.

Another example: Exercise may prevent or resolve 80% or more of diabetes, which is great, BUT that still leaves 10-20% (all the type-1s for a start) who you could exercise all day every day but it will not help. You cannot therefore say "diabetics, your meds are bad for you, forget the insulin and exercise instead". Even if you are right for 80% of them, you will kill the other 20%. We don't know exactly why those people have diabetes, but we do know there are significant genetic risk factors. You can't change your genes, you can't exercise them away, or diet them away.

Yes, definitely there are no guarantees. Another example is living as healthy as can be (even having perfect knowledge of that, which we are not even close to), but getting in a plane crash, etc. At this point in history (as well as all prior points) you are pretty much guaranteed your body will slowly stop functioning in a myriad of ways at some point as you get older. This is no matter what you do.

In your case, perhaps you contracted some weird virus strain at some point. Maybe it was even something like poison ivy you brushed up against one too many times, we still don't know why that substance is such a problem for some humans (but pretty anything else can eat it with no problem). Maybe you exercised too much without breaks and whatever is going on with delayed onset muscle soreness got to you.

My position is we lack basic info about almost everything regarding the human body (how many cells in each tissue at various ages, etc), so believing that anyone has the expertise to help you is a mistake. All they can do is try out different things and check if you seem to be improving, basically brute force on the acute symptoms while disregarding the long-term effects.

I don't know about this:

in fact the doctors couldn't understand why I was there in the hospital with a stroke in my 40s, I didn't appear as high risk in any way.[...]
I am now on half the drugs on your "dangerous" list, and a few more that really are (far more) dangerous, to keep me alive.

Why do you believe they have a handle on your problem now when they had no idea earlier? It is the old counterfactual problem, what would have happened if you didn't get input to the healthcare system? And keep in mind I really do think these concentrated chemicals can be useful tools, like putting some grease on the squeaky wheel in the drier.

Re:Highly concentreted chemical are not safe(Score: 0) by Anonymous Coward on Monday September 25 2017, @06:48PM

One thing I did not think of is that my thoughts on the matter are actually offensive to the people taking the meds, like you point out. Thank you for that. I would have thought more people would just go with whatever the experts say, so they are not to blame for the situation at all.

Re:Highly concentreted chemical are not safe(Score: 0) by Anonymous Coward on Monday September 25 2017, @07:02PM

A high percentage of people would be fine if they were on a proper diet and exercised regularly, got some sun, etc. Most who've tried were using the wrong info, pushed to them by Big Food.

I do a lazy man's ketogenic diet and it's working wonders. 50% fat, 25% protein and 25% carbs, but only from vegetables. If i go more towards actual ketogenic (70% fat, 25% protein and 5% carbs. or something like that) than that's great, but i don't worry about it too much.

Great! Now I need a conversion chart for heroin.Great! Now I need a conversion chart for heroin.(Score: 5, Insightful) by captain_nifty on Monday September 25 2017, @02:56PM
(3 children)

This is the same type of crap as Sudafed. Sudafed doesn't even require a prescription, but because you can use it in the manufacture of methamphetamines, it is regulated. Really sucks if you need some for allergies or a cold and all you can buy is a low couple of days worth dosage, after waiting to speak to a pharmacist and having them track your ID. I saw a joke once that someone was looking for the reverse recipe, how to make Sudafed from meth, as meth was now easier to get. Sooner or later 'street pharmacists' aka drug dealers, are going to be required to meet legitimate pain management needs as doctors and pharmacists will just say no.

This extralegal removal of choice is stupid. For opioids you already need a medical professional to write you a prescription, now they have to have the pharmacy and insurance in the mix to make it harder to get medical supplies. It would be so nice to actually be responsible adults about it. It is a necessary medical supply for some, yes it can be abused. So instead of asking: Why do people abuse it? Can we do something to change the despair in society leading to addiction? or offer solutions to get out of addiction? Instead we limit the supply and criminalize mere possession of a thing, making it difficult for those with valid uses to obtain needed medical supplies, and driving an often violent and criminal alternative market.

It's almost like the powers that be want a permanent criminal underclass that they can exploit.

After you see so many policies, like the war on drugs, fail so spectacularly with respect to their stated goals; you have to assume that the stated goals are lies, and the actual outcomes are the real desired outcome.

Re:Great! Now I need a conversion chart for heroinRe:Great! Now I need a conversion chart for heroin(Score: 5, Informative) by c0lo on Monday September 25 2017, @03:51PM
(2 children)

Spreading the blame and ObfuscationSpreading the blame and Obfuscation(Score: 2, Interesting) by Anonymous Coward on Monday September 25 2017, @03:20PM
(2 children)

Why are they calling the Doctor if they suspect inappropriate/over prescription or false prescription? why not the local Medical association so that they can investigate the DOCTOR all this does is make life difficult for patients and will likely do nothing about the problem, the DOCTORS and the Drug companies are the responsible ones the pharmacies are just the distribution network they can detect problems in the system but they don't have the expertise or authority to investigate Medical associations, regulators do and huge drug companies can be forced to stop being pushers

The only reason to have CVS do this is to obscure who is actually in positions of responsibility further confuse the problem and make sure nothing is done and no one that is actually responsible is ever held to account.

Re:Spreading the blame and Obfuscation(Score: 2) by c0lo on Monday September 25 2017, @03:53PM

Re:Spreading the blame and Obfuscation(Score: 4, Interesting) by Runaway1956 on Monday September 25 2017, @04:45PM

There seems to be a misconception here. If your pharmacist calls your doctor, he is going to do so WHILE YOU ARE STANDING THERE WAITING. It has happened to me. He dials, a receptionist answers, the pharmacist identifies himself, and asks to speak to the doctor. Doctor gets on the line, and they discuss anything from "Is the generic brand alright for this patient?" to "This dosage looks wrong, shouldn't it be higher/lower?" on to "Are you aware that the patient has this condition and/or takes these other meds?"

Time consumption is measured in many seconds, to a few minutes. The phone call doesn't delay you by hours. Every time I've been present when the pharmacist called the doctor, the purpose was either to save money, or to clarify things the doctor MAY NOT have been aware of. Usually, I'm grateful that the pharmacist went to the trouble of calling the doctor, or if not grateful, then certainly not resentful.

What constitutes an epidemic?What constitutes an epidemic?(Score: 1) by Ken on Monday September 25 2017, @05:00PM
(6 children)

Is it a certain number of people affected, or a certain percentage of the population. In a very limited fashion I ran some numbers while reading a couple of articles. One was overdose deaths which I divided by U.S. population and came up with .02 percent. The other was opioid prescriptions in one state which I divided by that state's population and came up with 0.25 percent. I wish I could remember the articles. I just wonder if this "epidemic" is as bad as the media would have us believe.

Obviously the opioid epidemic is not nearly as large of a problem as they would have you believe. The war on drugs is a front and justification to preserve the harmful drug licensing system we have in the United States. If drugs were regulated less Big Pharma wouldn't profit as much, can't have that! So the dangers of drugs are over-hyped as an alternative justification for why these laws exist.

You do realize that before the FDA, it was common for the precursors to modern pharmaceuticals ("patent remedies"), to include opiates and other addictive substances, right? And that there was absolutely no guarantee that what is in the bottle bears any relationship at all with the label on it? Heck, you don't even need to look at what was going on a century ago: Products that purport to be herbal remedy and vitamin pills, which are not regulated by the FDA, have been tested by consumer groups and frequently discovered to not be at all what they claim to be.

Imagine taking your pills and having no idea if they are remotely what your doctor thinks you should take.

How about a comparison with something I think we can agree was a serious epidemic, namely AIDS?

AIDS has killed roughly 660,000 Americans since it was first encountered in 1981, or about 18,400 people a year on average. Heroin overdose killed about 3.5 times that last year. So yes, I don't think the word is being misused, except for the question of whether heroin addiction is considered a disease.

One of my best friends is a pharmacist and my wife is a tech. After hearing first hand about the shit some of these doctors do because they are inept, I am really glad we have people that actually know interactions

>doc perscribes eye drops for ear infection>doc perscribes too little antibiotic and makes kid sicker>doc gets a call from a school buddy with big pharma and perscribes 30 people the same drug for different purposes that has significant side effects>doc perscribes enough of wrong drug to kill patient>doc ignores continuous history of abuse and constantly does refills due to "lost" schedule A drugs

Made me kind of afraid of doctors.

--"I'd rather take a political risk for peace rather than risk peace in pursuit of politics" - President Donald J. Trump